Provider Demographics
NPI:1093007023
Name:NGUYEN, BEN GIA (DO)
Entity Type:Individual
Prefix:DR
First Name:BEN
Middle Name:GIA
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:DR
Other - First Name:BAO
Other - Middle Name:GIA
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7300 S WESTERN AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73139-2002
Mailing Address - Country:US
Mailing Address - Phone:405-622-4214
Mailing Address - Fax:405-622-4191
Practice Address - Street 1:7300 S WESTERN AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73139-2002
Practice Address - Country:US
Practice Address - Phone:405-622-4214
Practice Address - Fax:405-622-4191
Is Sole Proprietor?:No
Enumeration Date:2011-05-10
Last Update Date:2014-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5256390200000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program